Healthcare Provider Details

I. General information

NPI: 1497850432
Provider Name (Legal Business Name): ADVENTIST HEALTH SYSTEMS SUNBELT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7975 LAKE UNDERHILL ROAD SUITE 200
ORLANDO FL
32822
US

IV. Provider business mailing address

7975 LAKE UNDERHILL ROAD SUITE 200
ORLANDO FL
32822
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-6830
  • Fax: 407-303-8659
Mailing address:
  • Phone: 407-303-6830
  • Fax: 407-303-8659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MR. DARYL TOL
Title or Position: PRESIDENT/CED
Credential:
Phone: 407-303-1531